Actually, I'm New Here Myself

As the humorist Bill Bryson stated in a title of one of his books "Actually, I'm New Here Myself".  I volunteered to blog for a month for the Attention Deficit Disorder Organization (ADDA)* without the slightest idea of what anyone wants to read in a blog. That said, let me introduce myself to you. I'm a retired physician with a specialty in internal medicine and subspecialty in adolescent medicine. As I get older, I do demonstrate some of the symptoms of ADHD but suspect I do not have ADHD; however a while back I was asked to be on the board of ADDA because of my interest in ADHD. (For simplicity, I will refer to ADD and ADHD as ADD.)

Why An Interest in ADD?

A number of my adolescent patients were diagnosed with ADD and were referred to me for medication treatment of ADD starting in the early 1970s. Later in my career, several young physicians who were training at my medical center were referred to me because of difficulty in preparing for the specialty board exams, attention problems in lectures, or behavioral problems such as persistent tardiness or intermittent impulsive behavior. More recently, one of my fellows, a pediatrician being trained in the adolescent medicine fellowship program which I directed, had been diagnosed in childhood with ADD and was having organizational performance difficulties. I have been privileged to work with these bright young adults and, while partnering with them to find strategies and sometimes medications to improve their lives, have come to several conclusions which are now backed up with recent research:

• All folks with ADD do not "outgrow it." In fact, sixty percent of those diagnosed in childhood continue to have challenges with ADD and may benefit from counseling and/or medications.

• Adults with ADD are not stupid, crazy or lazy. (Yes, I know this is a paraphrase of the title of a well-known book on adult ADD.)  Please see the number of well known business leaders, artists, athletes, performers and researchers who are self reported to be challenged with ADD on this HealthCentral site. In my experience, none of the physicians I worked with were stupid, crazy, or lazy. In fact, as a group they tended to be more innovative, caring and tended to overwork compared to others at the same academic level although some seemed to under perform until ways to compensate for ADD were developed.

• Medications for ADD will not drive those who need these medications to a life of substance abuse. Recent research actually indicates that adolescents with ADD, appropriately prescribed ADD medication, have a decreased risk of substance abuse compared to those with ADD who are not treated with medication. In addition, those with medication treated ADD have a no higher risk of substance abuse than adults without ADD.

• The individual with ADD working with a coach/psychologist or other knowledgeable support person can design personal strategies that compensate for many of the challenges of ADD. For instance, my fellow started using a workbook with daily notes and assignments to keep her on track. I learned this was an excellent strategy for all my fellows - even those who did not have ADD - and at the start of each year gave them all a nice thick multi-division notebook to keep schedules, assignments, organizational notes, etc. in one place and which they were to always have with them while working.

• Fidgeting can actually focus concentration. (I learned this recently from another book, Fidgeting to Focus, which presents scientific evidence for this.) I probably shouldn't tell you this (shhhhh!), but many of the ADDA Board members, all of whom are highly accomplished entrepreneurs, professionals, and administrators actually bring toys to crunch and play with so they can focus at our Board meetings. Since I present the treasurer's report, I welcome this since I know they are more likely to stay awake and focus.